What are the responsibilities and job description for the Revenue Cycle Audit & Appeals Specialist position at Massachusetts Health & Hospital Association?
Role: Licensed Registered Nurse responsible for managing insurance appeals, overseeing CMS audits, and conducting financial analysis to ensure compliance and audit readiness.
Responsibilities
Responsibilities
- Handle insurance denials and appeals efficiently.
- Manage and prepare for CMS audits through detailed financial analysis.
- Ensure compliance with healthcare regulations and guidelines.
- Minimum of 3 years of experience in acute care or audit roles.
- Familiarity with Miliman/Interqual guidelines.
- Strong analytical, organizational, and communication skills.